Unstable angina requires outpatient exercise stress testing.

• A. True
• B. False
• C. Not recommended
• D. Only with negative troponin

Answer: (B)

Unstable angina is an acute coronary syndrome where the heart is currently at risk of ongoing ischemia or infarction. In this situation, the priority is rapid stabilization and close monitoring in the hospital, with anti-ischemic and antithrombotic therapy and usually early invasive evaluation. An exercise stress test during the unstable phase can provoke further ischemia, arrhythmias, or deterioration, even if troponin is not yet elevated. Because of those risks, outpatient exercise testing is not appropriate in unstable angina. Once the patient has stabilized and chest pain has resolved, stress testing may be considered later to assess stable ischemia, but not as an acute outpatient test.